Healthcare Provider Details

I. General information

NPI: 1760932172
Provider Name (Legal Business Name): HOLSMAN PT REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2016
Last Update Date: 10/10/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 MONTGOMERY ST
JERSEY CITY NJ
07302-3345
US

IV. Provider business mailing address

710 MILL ST UNIT H3
BELLEVILLE NJ
07109-5318
US

V. Phone/Fax

Practice location:
  • Phone: 201-932-2656
  • Fax: 201-603-2454
Mailing address:
  • Phone: 973-759-1494
  • Fax: 973-759-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number40QA00978900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number46TR00514000
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00629500
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD HOLSMAN
Title or Position: PRESIDENT
Credential: DPT, GCS
Phone: 973-393-5545